Effect of Lime and Gypsum on Engineering Properties of Badarpur Fly Ash

The present study was conducted to investigate the performance of Badarpur fly ash stabilized with lime and gypsum. The work investigates the effect of lime (4%, 8%, 12% and 16% by mass of dry fly ash) and gypsum (1%) on compaction (in terms of density/moisture relationship), unconfined compressive strength (UCS), California bearing ratio (CBR), split tensile strength, and resilient modulus of fly ash. Based on strength, fly ash stabilized using 12% lime and 1% gypsum was observed as the highest strength mix. The microstructural development of the stabilized mix was studied through SEM and XRD. The results showed that Badarpur fly ash acquired UCS of 4697 kPa, CBR of 73% after 28 days of curing, split tensile strength of 630 kPa, and resilient modulus of 651 kPa. The strength increases with curing period and the composite achieved strength of 6150 kPa after 90 days of curing. This stabilized Badarpur fly ash can be utilized as road construction material

Assessment of carrot growth performance with inoculation of AsT-PGPR under arsenic infested zone

In the present study, the maximum rhizobacterial population was observed in Nutrient Agar (NA) (average; Cfu=135×106) followed by King’s-B (average; Cfu=57×106), Soil extract agar (SEA) (average; Cfu=11×106), and Trypticase soy agar (TSA) (average; Cfu=9×106). Screening of arsenic tolerant rhizobacterial isolate revealed that about 1% of the bacterial isolate was from Nutrient Agar and King’s-B survived at 20ppb arsenic concentration, while 0.8% and 0.7% survived from TSA and SEA media respectively. 50ppb arsenic tolerant rhizobacteria were screened for plant growth-promoting activity such as IAA, Phosphate solubilization, Siderophore production, ACC deaminase activity. Maximum IAA activity was observed in rhizobacterial isolates, isolated from all different media. P- solubilizer, Siderophore producer, ACC deaminase, proline, and TSS activities were observed in the isolates of NA media followed by King’s-B media. 50ppb tolerate best suitable PGP traits producing isolates were inoculated to observe carrot plant growth in the pot experiment, Interesting and significant (p<0.05) result were observed in King’s-B media producer isolates; (Pseudomonas) induces plant length, chlorophyll-a and chlorophyll-b content of the plant after 60 days followed by 30 days

Identification of Comamonas species using 16S rRNA gene sequence

A bacterial strain Bz02 was isolated from a water sample collected from river Gomti at the Indian city of Lucknow. We characterized the strain using 16S rRNA sequence. Phylogenetic analysis showed that the strain formed a monophyletic clade with members of the genus Comamonas. The closest phylogenetic relative was Comamonas testosteroni with 95% 16S rRNA gene sequence similarity. It is proposed that the identified strain Bz02 be assigned as the type strain of a species of the genus Comamonas (Comamonas sp Bz02) based on 16S rRNA gene sequence search in Ribosomal Database Project, small subunit rRNA and large subunit rRNA databases together with the phylogenetic tree analysis. The sequence is deposted in GenBank with the accession number FJ211417

Does 3-Day Course of Oral Amoxycillin Benefit Children of Non-Severe Pneumonia with Wheeze: A Multicentric Randomised Controlled Trial

WHO-defined pneumonias, treated with antibiotics, are responsible for a significant proportion of childhood morbidity and mortality in the developing countries. Since substantial proportion pneumonias have a viral etiology, where children are more likely to present with wheeze, there is a concern that currently antibiotics are being over-prescribed for it. Hence the current trial was conducted with the objective to show the therapeutic equivalence of two treatments (placebo and amoxycillin) for children presenting with non-severe pneumonia with wheeze, who have persistent fast breathing after nebulisation with salbutamol, and have normal chest radiograph.This multi-centric, randomised placebo controlled double blind clinical trial intended to investigate equivalent efficacy of placebo and amoxicillin and was conducted in ambulatory care settings in eight government hospitals in India. Participants were children aged 2-59 months of age, who received either oral amoxycillin (31-54 mg/Kg/day, in three divided doses for three days) or placebo, and standard bronchodilator therapy. Primary outcome was clinical failure on or before day- 4.We randomized 836 cases in placebo and 835 in amoxycillin group. Clinical failures occurred in 201 (24.0%) on placebo and 166 (19.9%) on amoxycillin (risk difference 4.2% in favour of antibiotic, 95% CI: 0.2 to 8.1). Adherence for both placebo and amoxycillin was >96% and 98.9% subjects were followed up on day- 4. Clinical failure was associated with (i) placebo treatment (adjusted OR = 1.28, 95% CI: 1.01 to1.62), (ii) excess respiratory rate of >10 breaths per minute (adjusted OR = 1.51, 95% CI: 1.19, 1.92), (iii) vomiting at enrolment (adjusted OR = 1.49, 95% CI: 1.13, 1.96), (iv) history of use of broncho-dilators (adjusted OR = 1.71, 95% CI: 1.30, 2.24) and (v) non-adherence (adjusted OR = 8.06, 95% CI: 4.36, 14.92).Treating children with non-severe pneumonia and wheeze with a placebo is not equivalent to treatment with oral amoxycillin.ClinicalTrials.gov NCT00407394

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Comparison of efficacy of intralesional triamcinolone acetonide at 2-, 4-, and 6-week intervals in hypertrophic scars and keloids

Context: Keloids and hypertrophic scars are a cause of severe impairment of quality of life. Intralesional triamcinolone acetonide has been used at different intervals at various centers. Aim: This study was aimed to compare the efficacy of intralesional triamcinolone acetonide at 2-, 4-, and 6-week intervals in hypertrophic scars and keloids. Settings and Design: This study was conducted in the plastic surgery outpatient department of a tertiary care hospital. This is an interventional prospective study, randomization was done using a computer-generated sequence. Materials and Methods: In this study conducted from October 2015 to January 2017, administration of triamcinolone acetonide 40 mg/ml at 2-weekly, 4-weekly, and 6-weekly intervals was done in case of hypertrophic scars and keloids for up to 8 doses or till Vancouver Scar (VCS) scale of 4 was achieved. VCS, pain, and itching were noted and compared. Statistical Analysis: VCS scale was used for comparison using analysis of variance test. The visual analog scale was compared using an unpaired t-test. Qualitative data were compared using the Chi-square test/Fischer's exact test. P < 0.05 was considered statistically significant. Results: The 2-weekly regimen was found to show better results in terms of pain and scar improvement. It also required a lesser number of doses to produce the same effect. The response to itching was comparable in 2- and 4-weekly groups and was better than 6-weekly group. Minimal complications were noted in the three groups. Conclusion: Two-weekly regimen of triamcinolone acetonide is recommended for intralesional use in hypertrophic scars and keloids

Giant Myofibroblastoma of the Male Breast: A Case Report and Literature Review

Myofibroblastomas are soft-tissue neoplasms that are thought to arise from myofibroblasts. They are mostly observed in males 41–85 years of age; however, this lesion also occurs in women. The usual clinical presentation is a unilateral painless lump that is not adherent to overlying or underlying structures. Microscopically, myofibroblastomas can be divided into 5 subtypes: classical, epithelioid, collagenised, cellular, and infiltrative. Mammary ducts and lobules are absent in the typical histological subtypes and the adjacent breast parenchyma may form a pseudocapsule. The majority of myofibroblastomas are immunoreactive for CD34, desmin, smooth muscle actin, and vimentin and are negative for cytokeratin and S-100 protein. We present a case of a giant myofibroblastoma arising in the background of gynecomastia in an adult male

Dual-purpose Injectable Doxorubicin Conjugated Alginate Gel Containing Polycaprolactone Microparticles for Anti-Cancer and Anti-Inflammatory Therapy

In situ gel formulations have been widely reported as a carrier for sustained release delivery systems due to certain advantages such as targeted drug delivery, minimal invasiveness and potent therapeutic activity. Herein, in situ gel system for sustained release of doxorubicin and ibuprofen for anti-cancer and anti-inflammatory activity is reported. Doxorubicin-conjugated alginate (dox-alg) gel was prepared using EDC-NHS chemistry and loaded with ibuprofen encapsulated polycaprolactone (PCL) microparticles (dox-alg composite). PCL microparticles were prepared by a solvent evaporation method (size 50 - 100µm). The gel was characterized using SEM, FTIR, XRD and TGA analysis. Dox-alg composite gel showed good syringeability and gel formation properties. Burst release was observed for both drugs within 24 h followed by sustained release till day 21. Doxorubicin released from composite showed considerable cytotoxic effect. Cell uptake was confirmed by confocal microscopy using MDA-MB-231 cells. Anti-inflammatory activity of ibuprofen released from composite gel was compared with the free drug. An injection of dox-alg composite gel in the tissue would fill the void created after tumor removal surgery, prevent the resuscitation of remnant cancerous cells and reduce inflammation. Thus, the dox-alg composite gel could be a potential agent for the dual anti-cancer and anti-inflammatory therapy

Urogenital anomalies associated with anorectal malformation

Background : The objective of the paper is to review the incidence and types of associated urogenital anomalies (U.G.A.) we encountered in patients with anorectal malformations (A.R.M.) and compare the results with previously published world literature. Materials and Methods: Retrospective review was done of 220 cases of A.R.M., treated from May 2002 to April 2003. All patients routinely underwent ultrasound (U.S.) study of the K.U.B. region and pelvis and lumbosacral radiography. Voiding cystourethrography (V.C.U.G.), nuclear renography and other investigations like buccal smear and karyotyping were done in selected cases only. Results: Genital anomalies were found in 30 cases (13.63%) and urologic anomalies in 25 cases (11.36%), a direct correlation being found between the level of A.R.M. and the incidence of urogenital anomalies (U.G.A.). Conclusion: The high incidence of associated anomalies (24.54%) makes careful clinical examination and evaluation of the urinary tract during the neonatal or early infantile period mandatory in all cases of A.R.M., particularly to avoid deterioration of renal function in future